Zambian AIDS Hospice Provides Comfort, Care

Zambia is one of nine countries hard hit by the AIDS pandemic in
sub-Saharan Africa. Dr. Michael
Bush is a senior medical advisor at a hospice for Zambia's terminally ill
patients. The 120-bed hospice is located about 15 kilometers from Lusaka in
Chilanga Township. It sits in a small, clean block of green lawns, hostels and
a church. It's more often called Mother of Mercy hospice because of the care
it's currently giving to 350 poor, outcast, and terminally ill patients with
HIV/AIDS. The hospice was established in 1989 with donations from well-wishers
and Christian organizations.

Dr.
Bush says the patients are near the end of their lives and need home care. But
many have been rejected by their families and live alone in their huts. He says
the hospice gives the type of care the government and even families are not
providing.

"Part
of our aim is to build hospices in Africa for people who are severely ill,
terminally ill, but have nowhere to go. Rather than die in the corner of the
hut, in really atrocious circumstances, it was better to bring them into the
hospice where they could have care that they needed (so) that they could die
with dignity, they could be cleaned, they could be specially taken care
of…their physical needs taken care of and their psychological needs taken care
of. People who are close to death often have a lot of psychological and
spiritual problems as well, and these are taken care of at the hospice," he
says.

Although
officially a Catholic institution, Mother of Mercy provides medical, emotional
and physical care to many religious and ethnic groupings, including Moslems,
Christians and Jews.

The
government and international donors are working to contain the epidemic. For
example, the government provides free antiretroviral drugs to over 150,000
people living with HIV.

Dr.
Bush says, "The majority of the [HIV-positive] people that come into the
hospice are [also] infected with tuberculosis. We can treat TB, and we have at
our fingertips antiretroviral drugs given out free via the international
community. You know American money is channeled through various NGOs and they
supply drugs for free."

As
a result, the HIV prevalence rate among Zambia's 12 million people has
dropped from 16 to 14 per cent.

The
hospice is planning to open a school for AIDS orphans – children whose parents
died from the illness. Most of the children have no one to take care of them,
so they will live at the school and will be taken care of by the hospice volunteers.

There
are several hospices in different parts of Zambia. They supplement government
programs by working in communities that are challenged economically as well as
by hunger and disease. Most of the other hospices also provide care for
HIV/AIDS although they are not linked to the Catholic Church. Some are set up by families or individuals
with friends or family infected with HIV.

The
Treatment Advocacy and Literacy Campaign, TALC, is a leading Zambian advocacy
group that lobbies for fair access to AIDS treatment.

Clementine
Mumba is the group's chairperson. She
says the government should consider supporting hospices and donors and others
will help build more.

She
says the hospices do as well or better than government institutions that treat HIV patients, like the country's largest government-run treatment
center, University Teaching Hospital (UTH).

Mumba
says "(The hospices are doing a commendable job in that) When you look at the
situation at UTH and then compare them to some of these hospices, you will
agree with that they are far much better looked after and cared for (patients)
in terms of nutrition...The food they give the patients…in terms of the
cleanliness and also in the administration of the staff. I think they are doing
a very commendable job. [However], they are catering to a small number of people
in the nation [because they are] depending on well-wishers for the resources they
use at their institutions."

The
Zambian authorities say they cannot spend more than what is annually allocated
to the Ministry of Health. The government says it can only provide services
according to the availability of financial and material support.

Zambia
is one of the countries most affected by HIV in the world. About one million of an estimated 12 million
people are HIV positive.

Health
advocates estimate that nearly 500 Zambians die of AIDS-related illnesses each
day and people continue to get infected daily.

HIV/AIDS
has weakened the extended family system in Zambia. Also, widespread poverty,
unemployment and the burden of orphans makes it almost impossible for the
Zambian government to look after terminally ill people.

The
staff at Mother of Mercy Hospice says they recognize and support people living
with AIDS in what is still a stigmatizing environment.

Dr.
Bush says although the demand is high and resources limited, the hospice tries
to respond to every call it receives. He believes that most hospice patients
die without pain.